Table 3.
Summary of the selected studies concerning the association between alexithymia (Alex) and empathy
| Authors (year) | Participants | Measures | Main results (Empathy and Alex) | (QA JBI) | ||
|---|---|---|---|---|---|---|
| N | Age | Empathy | Alex | |||
| Al Aïn et al. (2013) | 107 | 23.9 (3.4) | BES | TAS-20 |
Empathy total score was negatively associated with alex total score (r = -0.28, p < .0.5). The following additional results were detected: TAS-20 DIF and BES total (r = 0.02, p = NS), affective (r = -0.17, p < .0.5), and cognitive (r = 0.13, p = NS). TAS-20 DDF and BES total (r = -0.33, p < .0.5), affective (r = -0.39, p < .0.5), and cognitive (r = -0.20, p < .0.5). TAS-20 EOT and BES total (r = -0.33, p < .0.5), affective (r = -0.38, p < .0.5), and cognitive (r = -0.21, p < .0.5). |
50% |
| Alkan Härtwig et al. (2020) | 34 (24 alex; 26 non-alex) |
Alex: 35.0 (10.5) Non-alex: 34.7 (10.1) |
IRI Multifaceted Empathy Task |
TAS-20 BVAQ OAS |
High alex participants reported significantly lower scores on empathy subscales of the IRI [Fantasy t(48) = -2.93, p = .011; Empathy t(48) = -3.24, p < .001; Perspective taking t(48) = -2.69, p = .047; Personal distress t(48) = 2.64 p = .045; Competence t(48) = -0.75, p = .456]. Moreover, high alex participants presented significantly lower emotional empathy than the controls, as shown in the main effect of group in ANOVA [F(1,46) = 8.25, p = .006] and in post hoc t-tests of Empathy-condition [t(48) = −2.59; p = .012]. | 80% |
| Aslan et al. (2021) | 376 | 20.9 (1.9) | Empathy Tendency Scale | TAS-20 | Empathy was negatively associated with alex (r = -0.34, p < .001). | 63% |
| Bogdanov et al. (2013) | 21 | N/A | Multidimensional Emotional Empathy Scale | TAS-20 | No significant relationship between empathy and alex was found (no data available). | 63% |
| Carré et al. (2013) | 370 | 26.1 (12.4) | BES | TAS-20 | No correlations between the BES-Affective and TAS-20 scores were found (all p = NS). Cognitive Empathy subscale correlated with TAS-20 total (r = -0.17, p < .05), DIF (r = -0.18, p < .05), and DDF (r = -0.21, p < .05) scores. | 75% |
| Christensen et al. (2018) | 40 (20 dancers; 20 non-dancers) |
Dancers: 25.4 (4.6) Non- dancer: 24.3 (53.9) |
IRI EES |
TAS-20 BVAQ |
No significant association between the IRI and TAS-20 and the EE and TAS-20 total scores was found (all p = NS). The IRI and EE total scores were negatively associated with the BVAQ total score (IRI, r = -0.35, p < .05; EE, r = -0.51, p < .001). | 70% |
| Colombarolli et al. (2019) | 850 | 31 (10.8) | QCAE | TAS-20 | Significant associations between alex and the following empathy scores were found: QCAE-Perspective taking: r = −0.27, p < .001; QCAE-Online simulation: r = -0.35, p < .001; QCAE-Proximal Responsivity: r = -0.09, p < .01; QCAE-Peripheral Responsivity: r = -0.16, p < .001; QCAE-Cognitive Empathy: r = -0.38, p < .001; QCAE-Total: r = -0.30, p < .001); QCAE-Emotion contagion: r = 0.22, p < .001). Significant associations between the TAS-20 subscale and QCAE subscale scores were found (all correlation results are not shown for space reasons.). | 88% |
| Demers & Koven (2015) | 86 | 18.9 (1.1) | QMEE | TAS-20 | Empathy was associated with two alex subscale scores (TAS-20 DIF: r = 0.27, p < .05; TAS-20 EOT: r = -0.41, p < .005). | 75% |
| Di Girolamo et al. (2019) | 285 | 26.4 (7.0) | QCAE | TAS-20 | Empathy total score was significantly associated with alex total (r = -0.27, p < .01), DDF (r = -0.22, p < .05), and EOT (r = -0.43, p < .01) scores. Cognitive empathy was significantly associated with alex total (r = -0.35 , p < .01), DDF (r = -0.25, p < .01), and EOT (r = -0.43, p < .01) scores. Afective empathy was significantly associated only with EOT scores (r = -0.26, p < .01). | 88% |
| Di Tella et al. (2020) | 260 | 21.2 (2.1) | IRI | TAS-20 | Alex was positively correlated with the Personal Distress subscale (r = 0.39, p < .01) and negatively correlated with the Perspective-Taking subscale (r = -0.35, p < .01) of the IRI. Results of the hierarchical regressions showed a significant predictive role of alex for all the IRI subscales (all p < .05). | 100% |
| Dierckx et al. (2021) | 506 (271 Black sample; 235 Muslim sample) |
Black sample: 27.9 (8.50) Muslim sample: 27.2 (8.50) |
IRI | TAS-20 | Empathy (Empathic Concern and Perspective Taking dimensions) was negatively associated with alex in both Black and Muslim samples (Black sample: Empathic Concern, r = -0.25, p < .001; Perspective Taking, r = -0.30, p < .001. Muslim sample: Empathic concern, r = -0.28, p < .001; Perspective Taking: r = -0.43, p < .001). | 60% |
| Diotaiuti et al. (2021) | 300 | 22 (2.6) | IRI | TAS-20 |
A significant correlation was found between IRI total and TAS-20 subscale scores (DIF, r = -0.19, p < .01; DDF, r = -0.11, p < .05; EOT, r = -0.48, p < .01). The TAS-20 total score was significantly correlated with the IRI Perspective Taking (r = -0.22, p < .01), Personal Distress (r = 0.35, p < .01), and Empathic Concern (r = -0.28, p < .05) subscale scores. Significant correlations also emerged between the DIF subscale and the IRI Personal Distress (r = -0.42, p < .01), Empathic Concern (r = -0.11, p < .05), and Fantasy (r = -0.23, p < .01) subscale scores and between the DDF and Personal Distress (r = -0.28, p < .01). The TAS-20 EOT subscale was significantly associated with the IRI Perspective Taking (r = -0.46, p < .01), Empathic Concern (r = -0.37, p < .05), and Fantasy (r = -0.32, p < .01) subscale scores. |
50% |
| Eddy & Hansen (2021) | 297 | 19.2 (1.2) | IRI | TAS-20 | Alex was associated with Perspective Taking (r = -0.33, p < .0001), Empathic Concern (r = -0.30, p < .0001), and Personal Distress (r = 0.21, p < .0001) subscales of the IRI. | 50% |
| Gleichgerrcht & Decety (2013) | 7584 | 44.6 (12.1) | IRI | TAS-20 | Significant diferences were found between physicians with alex, borderline and without alex on the Empathic Concern (F(2,1878) = 4.62, p < .01, d = .15), Personal Distress (F(2,1878) = 36.2, p < .001, d = .39), and Perspective Taking (F(2,1878) = 48.9, p < .001, d = .46), with alex participants showing less empathic skills than non-alex ones. Moreover, alex was associated with all empathy subscales (Empathic Concern: r = 0.21, p <.001; Perspective Taking: r = 0.23, p < .001; Personal Distress, r = 0.30, p < .001). | 88% |
| Goerlich et al. (2017) | 45 | 24.1 (3.2) | EQ | TAS-20 | Alex total score was negatively correlated with EQ total (r = -0.74, p < 0.001) and subscale scores (Cognitive empathy: r = -0.74; Emotional empathy: r = -0.66; Social empathy: r = -0.72; all p < .001). Significant associations were also found between the EQ total and the three subscales of the TAS-20 (DIF: r = -0.57; DDF: r = -0.69; EOT: r = -0.51; all p < .001). | 88% |
| Goerlich- Dobre et al. (2015) | 125 (70 women; 55 men) |
Women: 25.2 (5.6) Men: 25.6 (5.6) |
IRI | BVAQ | The cognitive dimension of alex was associated with both cognitive (Perspective Taking and Fantasy) (women: r = -0.75, p < .001; men: r = −0.59, p < .001) and affective (Empathic Concern and Personal Distress) empathy (women: r = -0.68, p < .001; men: r = -0.43, p < .001). The affective alex dimension was not significantly related to either empathy dimension, neither in women nor in men (p = NS). | 88% |
| Gökçen et al. (2016) | 121 | 18.4 (1.9) | Self- Assessment Manikin Faces Task | TAS-20 | A not significant association was found between alex and affective empathy performance (r = -0.11, p = 0.249). | 88% |
| Gossen et al. (2014) | 35 (15 high-EQ; 20 low- EQ) |
High-EQ: 23.5 (2.3) Low-EQ: 24.7 (6.0) |
EQ | TAS-20 | Significant differences were found in the TAS-20 total score between the high and low empathy groups, with the former reporting lower levels of alex than the latter (31.5 ± 10.7 vs. 49.2 ± 8.9, p < .0001, η2 = 0.46). | 80% |
| Grynberg et al. (2010) | 645 | 21.2 (3.0) | IRI | TAS-20 |
Alex total was associated with Personal Distress (r = 0.25, p < .001), Empathic Concern (r = -0.18, p < .001), and Perspective Taking (r = -0.28, p < .001) subscales. Significant correlations also emerged between the DIF subscale and the IRI Personal Distress (r = 0.32, p < .001), Perspective Taking (r = -0.14, p < .001), and Fantasy (r = 0.12, p < .01) subscale scores and between the DDF and both Personal Distress (r = 0.22, p < .01) and Perspective Taking (r = -0.18, p < .001). The TAS-20 EOT subscale was significantly associated with the IRI Perspective Taking (r = -0.37, p < .001), Empathic Concern (r = -0.24, p < .001), and Fantasy (r = -0.21, p < .001) subscale scores. |
75% |
| Hao et al. (2020) | 674 | 20 (1.2) | IRI | TAS-20 | A positive association was found between alex and both cognitive (Perspective Taking) (r = 0.09, p < .05) and affective (Empathic Concern) empathy (r = 0.09, p < .05). | 88% |
| Herrero-Fernández et al. (2022) | 395 | 36.3 (12.5) | IRI | TAS-20 | The DDF subscale of TAS-20 was associated with all the IRI subscales (Perspective Taking: r = -0.13, p < .01; Fantasy: r = 0.12, p < .05; Empathic Concern: r = 0.15, p < .01; Personal Distress: r = 0.45, p < .001); the DIF subscale was associated with Perspective Taking (r = -0.20, p < .001) and Personal Distress (r = 0.31, p < .001); the EOT subscale was associated with all the IRI subscales (Perspective Taking: r = -0.51, p < .001; Fantasy: r = -0.30, p < .001; Empathic Concern: r = -0.28, p < .001; Personal Distress: r = 0.18, p < .001). | 75% |
| Himichi et al. (2021) | 516 | 39.5 (11.1) | IRI | TAS-20 | Alex was associated with the Personal Distress (r = 0.44, p < .001), Empathic Concern (r = -0.28, p < .001), Perspective Taking (r = -0.09, p < .05), and Fantasy (r = 0.08, p < .10) subscales of the IRI. | 88% |
| Ignatova et al. (2022) | 210 | 25 (3.0) | TEQ | TAS-20 | A negative association between alex and empathy total scores (r = -0.18, p < .05) was found. | 63% |
| Jonason & Krause (2013) | 320 | 24.2 (7.3) | BES | TAS-20 | The cognitive component of empathy was associated with all facets of alex (DDF: r = -0.32, p < .01; DIF: r = -0.21, p < .01; EOT: r = -0.46, p < .01), while affective empathy correlated only with the EOT subscale of the TAS-20 (r = -0.46, p < .01). | 50% |
| Kamel (2013) | 332 | 34.7 (12.0) | MDEES | TAS-20 | Significant associations were found between empathy total and TAS-20 DDF (r = -0.06, p < .05) and EOT (r = -0.20, p < .05) subscale scores. | 63% |
| Karras et al. (2022) | 550 | 40.3 (15.5) | TEQ IRI | TAS-20 | Alex total score was significantly associated with the TEQ total score (r = -0.13, p < .01) and the Perspective Taking (r = -0.30, p < .001) and Personal Distress (r = 0.32, p < .001) subscale scores of the IRI. | 100% |
| Konrath et al. (2018) | 270 | 33.5 (11.6) | SITES | TAS-20 | Higher empathy scores were associated with lower scores on alex [TAS-20 total: r(270) = -.25, p < .001; DIF: r(270) = -.19, p = .002; DDF: r(270) = -.22, p < .001; EOT: r(270) = -.25, p < .001]. | 75% |
| Law et al. (2004) | 418 | N/A | EES | TAS-20 | The following associations between the TAS-20 DIF, DDF, and EOT subscale scores and the EES total score were detected: r = -0.09, r = -0.04, r = -0.40 (p-values are not available), respectively. | 75% |
| Lee et al. (2020) | 200 | 23.1 (2.7) | IRI | TAS-20 | A significant association between alexithymia total score and the cognitive empathy domain (Perspective Taking and Fantasy subscales) of the IRI was found (r = -0.22, p < .01). Cognitive empathy was also significantly correlated with the DDF (r = -0.19, p < .01) and EOT (r = -0.24, p < .01) subscales of the TAS-20. | 88% |
| Li et al. (2023) | 142 | 21.7 (2.3) | QCAE | TAS-20 | A significant association was found between the alex total score and the QCAE Cognitive empathy subscale score (r = -0.44, p < .001), whereas no significant correlation was detected between the former and the QCAE Affective empathy subscale (r = 0.18, p = NS). | 88% |
| Lockwood et al. (2013) | 110 | 21.9 (3.7) | Self-assessment manikin faces task | TAS-20 | A significant and negative association was found between the alex total score and the performance on the empathy task (r = -0.25, p < .05). | 75% |
| Lyvers et al. (2017) | 102 | 22.2 (N/A) | IRI | TAS-20 |
Significant associations were found between alex total score and the Perspective Taking (r = -0.40, p < .001), Empathic Concern (r = -0.38, p < .001), and Personal Distress (r = 0.31, p < .01) subscale scores of the IRI. Significant correlations also emerged between the TAS-20 DIF and DDF subscales and the IRI Personal Distress (r = 0.27, p < .01; r = 0.25, p < .05), Perspective Taking (r = -0.23, p < .05; r = -0.36, p < .001), and Empathic Concern (r = -0.22, p < .05; r = -0.34, p < .001) subscale scores. The TAS-20 EOT subscale was significantly correlated with all the IRI subscales: Perspective Taking (r = -0.40, p < .001), Fantasy (r = -0.32, p < .01), Empathic Concern (r = -0.37, p < .001), and Personal Distress (r = 0.21, p < .05). |
88% |
| Lyvers et al. (2018) | 161 | 22.6 (7.2) | IRI | TAS-20 | Significant associations were found between the TAS-20 DIF, DDF, and EOT subscales and the Personal Distress subscale of the IRI (r = 0.31, p < .001; r = 0.20, p < .05; r = 0.22, p < .01, respectively). In addition, significant correlations were detected between the EOT subscale score and the Perspective Taking (r = -0.30, p < .001), Fantasy (r = -0.29, p < .001), and Empathic Concern (r = -0.36, p < .001) subscale scores. | 88% |
| Lyvers et al. (2020a) | 205 | N/A | IRI | TAS-20 | No significant association was found between alex and empathy total scores (r = -0.03, p = NS). | 100% |
| Lyvers et al. (2020b) | 253 | 21.6 (3.4) | TEQ | TAS-20 | A significant and negative correlation was detected between alex and empathy total scores (r = -0.40, p < .01). | 88% |
| MacDonald & Price (2017) | 616 | 19.2 (1.4) | QCAE | TAS-20 | A significant and negative association was found between the TAS-20 total score and the QCAE Cognitive empathy subscale score (r = -0.31, p < .001), whereas no significant correlation was detected between the former and the QCAE Affective empathy subscale (r = -0.01, p = NS). | 100% |
| Martínez-Velázquez et al. (2017) | 49 (19 non-alex; 14 affective alex; 19 cognitive alex) |
Non-alex:22.4 (2.7) Affective alex: 22.1 (1.8) Cognitive alex: 21.0 (1.6) |
IRI | TAS-20 BVAQ | Significant differences between the affective, cognitive, and non- alex groups were found on the cognitive sub-score (Perspective Taking) of the IRI [F(2,46) = 8.39, p < .001, η2 = 0.27], particularly between cognitive and affective alex groups (p <.001). The affective sub-score (Fantasy, Empathic Concern, and Personal Distress) of the IRI [F(2,46) = 4.99, p < .011, η2 = 0.18] characterized the affective alex group: non-alex and cognitive alex groups reported greater scores than affective alex sample (p = .036). | 80% |
| Martínez-Velázquez et al. (2020) | 60 (31 women; 29 men) | Women: 20.9 (1.8) Men: 21.1 (2.4) | IRI | TAS-20 | The low-empathy group reported significantly higher alex total scores than the high-empathy group [t(58) = -4.94, p ≤ .001, d = -1.27]. Additionally, a negative correlation was observed between the IRI and TAS-20 total scores [r(58) = -0.58, p ≤ .001]. | 60% |
| Martingano et al. (2022) | 1253 | 27.6 (N/A) | IRI | TAS-20 |
Alex total score was significantly associated with the Perspective Taking (r = -0.25, p < .01), Empathic Concern (r = -0.29, p < .01), and Personal Distress (r = 0.35, p < .01) subscale scores of the IRI. Significant correlations were also found between the DIF subscale and the Perspective Taking (r = -.26, p < .01), Empathic Concern (r = -0.14, p < .01), Fantasy (r = -0.14, p < .01), and Personal Distress (r = 0.37, p < .01) subscales. The DDF facet was significantly related to the Perspective Taking (r = -.14, p < .01) and Personal Distress (r = 0.30, p < .01) subscales. Significant correlations were found between the EOT subscale and the Perspective Taking (r = -.23, p < .01), Empathic Concern (r = -0.39, p < .01), Fantasy (r = -0.24, p < .01), and Personal Distress (r = 0.06, p < .05) subscales. |
88% |
| Mayer et al. (1990) | 139 | N/A | EES | TAS-26 | No significant association between alex and empathy total scores were found (r = 0.01, p = NS). | 50% |
| Mensi et al. (2023) | 58 families | N/A | EQ | TAS-20 | Alex total score was negatively associated with the EQ total score in both fathers (r = -0.41, p = .003) and mothers (r = -0.29, p = .039) of children with autism spectrum disorders. | 63% |
| Morice-Ramat et al. (2018) | 137 | 26.5 (1.3) | JSPE | TAS-20 | A negative correlation between alex and empathy total scores was found [r(135) = -0.38, p < .001]. | 63% |
| Moriguchi et al. (2006) | 30 (14 non-alex;16 alex) |
Total: 20.4 (0.9) Non-alex: 20.8 (0.9) Alex: 20.2 (1.0) |
IRI | TAS-20 SIBIQ | Alex participants reported significantly lower scores on the Perspective Taking (14.6 ± 3.5 vs. 18.5 ± 4.7, t = 2.64, p = .014) and Empathic Concern (16.1 ± 5.0 vs. 20.2 ± 3.7, t = 2.59, p = .015) subscales, while they reported higher scores on the Personal Distress (15.6 ± 4.1 vs. 12.2 ± 3.8, t = -2.37, p = .025) subscale of the IRI compared to non-alex individuals. | 80% |
| Moriguchi et al. (2007) | 30 (14 non- alex;16 alex) |
Total: 20.4 (0.9) Non-alex: 20.8 (0.9) Alex: 20.2 (1.0) |
EES IRI |
TAS-20 SIBIQ | Participants high in alex reported significantly lower scores on the Perspective Taking (14.6 ± 3.4 vs. 18.5 ± 4.9, t = 2.61, p < .05) and Empathic Concern (16.1 ± 4.9 vs. 20.0 ± 3.7, t = 2.48, p < .05) subscales of the IRI and on the Warmth subscale of the EES (49.2 ± 7.9 vs. 58.0 ± 3.2, t = 3.93, p < .05) compared to non-alex individuals. Conversely, alex participants reported higher scores, compared to non-alex ones, on the Personal Distress (15.8 ± 4.1 vs. 12.5 ± 3.7, t = -2.31, p < .05) subscale of the IRI. | 80% |
| Nam et al. (2020) | 200 (129 non- alex;71 alex) |
Non-alex: 23.3 (2.6) Alex: 22.7 (2.7) |
EQ IRI |
TAS-20 |
Participants high in alex reported significantly different scores on the Perspective Taking (17.93 ± 3.75 vs. 19.13 ± 4.11, t = 4.16, p = .043, η2 = .02) and Personal distress (16.21 ± 4.80 vs. 12.56 ± 5.54, t = 21.84, p <.001, η2 = .10) subscales of the IRI. Also, alex participants showed significantly lower scores on the Perception and expression of emotion (34.90 ± 5.06 vs. 38.56 ± 3.99, t = 31.64, p <.001, η2 = .14), Integrate emotion to facilitate thought (35.15 ± 5.22 vs. 36.87 ± 4.71, t = 5.61, p = .019, η2 = .03), Use of emotions (33.86 ± 4.32 vs. 35.26 ± 3.84, t = 5.53, p = .020, η2 = .03), and Regulation of emotions (31.46 ± 5.47 vs. 34.26 ± 5.21, t = 12.74, p <.001, η2 = .06) subscales of the EQ compared to non-alex individuals. Significant associations between the TAS-20 subscale and both the IRI and EQ subscale scores were found (all correlation results are not shown for space reasons). |
80% |
| Patil & Silani (2014a) | 295 | 25.0 (N/A) | IRI | TAS-20 | Alex total score was associated with reduced scores on the Empathic Concern (odds ratio = 0.9704, 95% CI [0.95, 0.99]) and Perspective Taking (odds ratio = 0.9724, 95% CI [0.95, 0.99]), as well as increased scores on the Personal Distress (odds ratio = 1.0434, 95% CI [1.03,1.07]) subscales of the IRI. | 100% |
| Patil & Silani (2014b) | 331 | 24.1 (5.5) | IRI | TAS-20 | Alex total score was associated with higher likelihood of reporting both lower scores on the Perspective Taking (odds ratio = 0.982, 95% CI [0.96,1.00]) and Empathic Concern (odds ratio = 0.979, 95% CI [0.96,1.00]), as well as higher scores on the Personal Distress (odds ratio = 1.051, 95% CI [1.03,1.07]) subscales of the IRI. | 100% |
| Pellicano et al. (2020) | 34 | 23.4 (2.7) | IRI | TAS-20 | Significant associations were found only between the IRI Personal Distress subscale and the TAS-20 total (r = 0.70, p < .001), DIF (r = 0.55, p < .001), and DDF (r = 0.61, p < .001) scores. | 75% |
| Preti et al. (2011) | 256 | 24 (4.5) | EQ | TAS-20 | Alex total score was significantly associated with the EQ Cognitive Empathy (r = -0.20, p < .01) and Emotional Reactivity (r = -0.51, p < .001) subscale scores. | 50% |
| Riccio et al. (2020) | 391 | 20.4 (4.9) | BES | TAS-20 | A significant association between alexithymia total score and the BES Cognitive empathy subscale score (r = -0.39, p < .001) was found. | 63% |
| Saito et al. (2016) | 78 | 20.5 (1.4) | Affective response questionnaire | Galex | High alex individuals were able to provide significantly higher other-oriented affective responses (advanced affective empathy) when they had (vs. had not) been instructed to distinguish others from themselves (β = 0.36, p = .02). | 63% |
| Schimmenti et al. (2019) | 799 | 35.8 (11.0) | EQ | TAS-20 |
Alex total score was significantly associated with the EQ total (r = -0.36, p < .01) and subscale (Cognitive Empathy: r = -0.15, p < .01; Emotional Reactivity: r = -0.37, p < .001; Social Skills: r = -0.39, p < .01) scores. Significant associations were also detected between the TAS-20 DIF, DDF, and EOT subscales and the EQ total (r = -0.29, p < .01; r = -0.24, p < .01; r = -0.24, p < .01) and subscale (Cognitive Empathy: r = -0.12, p < .01; r = -0.08, p < .05; r = -0.11, p < .01. Emotional Reactivity: r = -0.26, p < .001; r = -0.24, p < .001; r = -0.27, p < .001. Social Skills: r = -0.33, p < .01; r = -0.30, p < .01; r = -0.20, p < .01) scores. |
88% |
| Senese et al. (2018) | 633 | 24.3 (5.9) | EQ | TAS-20 | Alex total score was significantly associated with the EQ total (r = -0.31, p < .001) and subscale (Cognitive Empathy: r = -0.13, p < .01; Emotional Reactivity: r = -0.16, p < .001; Social Skills: r = -0.36, p < .001) scores. | 88% |
| Shah (2019) | 306 | 34.0 (11.9) | QCAE | TAS-20 | Significant and negative associations were found between alex total score and the QCAE total (r = -0.39, p < .001) and subscale (Cognitive: r = -0.44, p < .001; Affective: r = -0.19, p < .01) scores. | 50% |
| Shalev & Uzefovsky (2020) | 671 | 24.5 (2.5) |
EQ IRI |
TAS-20 | Significant and negative associations were detected between alex total score and both the EQ (r = -0.49, p < .001) and IRI (r = -0.17, p < .001) total scores. | 100% |
| Sonnby-Borgström (2009) | 102 | 24 (N/A) | IRI | TAS-20 | Negative associations were found between alex total score and the following IRI subscale scores: Perspective Taking (r = -0.25, p < .05), Fantasy (r = -0.20, p < .05), and Empathic Concern (r = -0.20, p < .05). | 63% |
| Stinson et al. (2022) | 824 | N/A | QCAE | TAS-20 | Negative associations were detected between alex total score and the following empathy scores: QCAE-Cognitive Empathy (r = -0.38, p < .001) and QCAE-Responsiveness to Others (r = -0.15, p < .001). | 88% |
| Swart et al. (2009) | 34 (18 non-alex; 16 alex) |
Non-alex: 19.3 (1.0) Alex: 20.1 (1.7) |
EQ | BVAQ | Alex individuals reported lower empathy scores than non-alex ones [34.2 ± 14.5 vs. 45.7 ± 10.1, F(1,32) = 7.31, p < .01]. | 70% |
| Tremblay et al. (2021) |
Study 1: 59 Study 2: 56 |
Study 1: 25.7 (9.1) Study 2: 22.1 (3.5) |
IRI | TAS-20 | A non-significant association was found between alex and empathy scores (r = -0.15, p > .05) in the first sample of participants (aged between 18 and 60), while a significant correlation between these two constructs was detected (r = -0.37, p < .01) in the second sample of young adults only. | 63% |
| Vellante et al. (2013) | 200 | 24.1 (2.8) | EQ | TAS-20 | A negative association was detected between alex and empathy (r = -0.41 , p < .001). | 63% |
| Yang et al. (2020) | 820 | 20.0 (1.3) | IRI | TAS-20 | Positive edges (network analysis approach) were found only between the DIF subscale of the TAS-20 and the Personal Distress subscale of the IRI. | 50% |
| Yang (2022et ) al. | 114 | 20.2 (0.2) | QCAE | TAS-20 | Alex empathy total total score score was significantly (r = 0.30, p < associated .01). with | 75% |
| Zhang W. et al. (2023) | 100 | 20.5 (2.3) | Picture-based and text- based pain empathy task | TAS-20 | Alex was not significantly associated with empathy for others’ pain in either condition (p > .05). | 88% |
| Zhang Y. et al. (2022) | 888 | 21.1 (1.6) | IRI | TAS-20 | A significant association was found between alex total and empathy total scores (r = -0.34, p < .01). | 88% |
QA (JBI) = Quality Assessment (Joanna Briggs Institute); BES = Basic Empathy Scale; TAS‐20 = Toronto Alexithymia Scale; TAS- 20 DIF = Difficulty Identifying Feelings; TAS-20 DDF = Difficulty Describing Feelings; TAS-20 EOT = Externally Oriented Thinking; IRI = Interpersonal Reactivity Scale; OAS = Observer Alexithymia Scale; BVAQ = Bermond Vorst Alexithymia Scale; EES = Emotional Empathy Scale; QCAE = Questionnaire for Cognitive and Affective Empathy; QMEE = Questionnaire Measure of Emotional Empathy; EQ = Empathy Quotient; MDEES = Multidimensional Emotional Empathy Scale; TEQ = Toronto Empathy Questionnaire; SITES = Single Item Trait Empathy Scale; JSPE = Jefferson Scale of Physicians Empathy; Galex = Gotow Alexithymia Questionnaire.
Note. Age is expressed in years; NS = not significant.